Histomorphological features of resected bladder tumors: Do energy source makes any difference

Area of Science:

• Urology
• Surgical Pathology

Background:

• Bipolar energy's use in bladder tumor resection raises questions about current density and its impact on transurethral resection of bladder tumor (TURBT) chip histopathology.
• Understanding these effects is crucial for accurate diagnosis and treatment planning.

Purpose of the Study:

• To compare the histomorphological features of bladder tumors resected using bipolar versus conventional monopolar energy.
• To evaluate the incidence and severity of cautery artifacts in specimens from both techniques.

Main Methods:

• A comparative study involving 61 patients with primary bladder carcinoma undergoing TURBT.
• Patients were divided into two groups: bipolar-TURBT (B-TURBT, n=31) and monopolar-TURBT (M-TURBT, n=30).
• Two blinded pathologists assessed resected tissue for cautery artifact severity (absent, mild, moderate, severe).

Main Results:

• No statistically significant differences were observed in mean age, tumor size, or resection time between the B-TURBT and M-TURBT groups.
• Pathologists could diagnose all specimens without obscurity.
• The distribution of cautery artifact grades (absent, mild, moderate, severe) was similar between the two groups, with no significant histomorphological dissimilarities.

Conclusions:

• Transurethral resection of bladder tumor (TURBT) using bipolar energy results in bladder tissue with histomorphological features equivalent to those obtained with standard monopolar TURBT.
• Bipolar energy is a viable alternative for bladder tumor resection without compromising histopathological evaluation.